Glass half full

The recent ABPI/CBI industry survey makes depressing reading, but there is hope for a new era of engagement

I have been diagnosed as an optimist, an affliction for which the industry has yet to invent a cure. This is fortunate, for if I were cured, I could certainly not do my job.

We have just completed the latest ABPI/CBI survey of the industry and its environment. Some 47 companies – a majority of our members – responded, and I went through the key results at the ABPI manifesto launch meeting.

Most of it makes pretty depressing reading. Half of the companies expect a worsened environment in the next 12 months (although that's better than the 80 per cent-plus in that position last year, in the final stages of the PPRS negotiation). Three-quarters do not see the UK as an attractive place to do business, when viewed in a global context, and that is in large measure because policy and regulations here are seen as inappropriate for the new pharma business model.

I can understand why. The new business model is bringing us high value/high price 'niche' products, many of which experience major problems at NICE and, even when they get a green light, are taken up slowly by the NHS. This issue is centrally important for the ABPI and we have been grappling with it in the course of the PPRS negotiations, the Kennedy Review and now the Office for Life Sciences (OLS).

But the greatest cause for optimism, for me, was that three-quarters of the companies are changing the way they work with the NHS. Not before time. The way in which we operated in the past – which focused largely on the prescriber and saw the higher-level decision makers as a barrier – has resulted in a set of relationships with the NHS that are now a hindrance to business success.

This is now changing, and changing fast. As a result of the pioneering work we have done with many companies in joint working projects across England, and now increasingly in Wales and Scotland, industry is developing business-to-business relationships that are fundamentally repositioning the industry for the better, as a partner in addressing disease epidemics cost-effectively.

We need new skills and new standard operating procedures to bring this off; skills in designing joint working projects, whether they be single-company or via groups of companies that will all benefit when the water level rises. Plus, we need skills in developing and presenting the economic case, alongside the clinical case, to financially hard-pressed NHS managers. And we now have comprehensive guidance to ensure that the ABPI Code does not act to inhibit, but rather to encourage, joint working for the benefit of patients and the NHS.

The data point from the survey that did depress me was that slightly more than half of companies responding believed the Office for Life Sciences would make no difference to our environment.

Of course, that would be a personal blow, since the ABPI argued for it at the Prime Minister's summit and our members have poured many long hours into its work. But, more importantly, I think it points to a mindset of scepticism, perhaps even cynicism, among some that nothing a government can be persuaded to do can make a positive difference. Even when, as in this case, the activity is headed by Lord Drayson, who is someone from the industry, when the industry has set the agenda and staffed the activity and when early progress like the “innovation pass” is clearly targeted at one of the core problems we have.

This is where I think we need a big dose of optimism.

A recent survey of policymakers across Europe, conducted by the European Federation for Pharmaceutical Industries and Associations (EFPIA), has some interesting findings. Industry messages of how tough the world is for us are falling on deaf ears, especially when political opinion leaders are intervening to save other industries from outright bankruptcy. It is much more effective for industry to stress the future scientific and economic growth that it represents, and the unmet patient need it is addressing.

As a result of a lot of senior dialogue with the medical research community and the NHS, and the recommendations of the OLS, we are opening up a new era of engagement. We will have the opportunity to develop new "clusters of capability" in translational medicine, and to work with SHAs and PCTs on specific diseases, to "find and treat" early stage patients and embed new, best practice, care delivery models that utilise medicines more effectively. In partnership.

But to play our role in this new era, we need to be forward-looking, "glass half full" people. It's a call to optimists.

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